How Much Does Therapeutic Plasma Exchange (TPE) Cost in NYC?

A single session of therapeutic plasma exchange runs between $6,000 and $15,000 nationally, depending on the clinic, the protocol, and whether intravenous immunoglobulin (IVIG) is included. In New York City specifically, published pricing at the three active TPE clinics ranges from $8,000 to $10,000 per session. Most patients who commit to an ongoing program spend $12,000 to $36,000 or more per year. It is not covered by insurance for longevity or anti-aging purposes. That is the honest answer, and the rest of this page explains what you get for that number.

What You're Actually Paying For in a TPE Session

Therapeutic plasma exchange is not an IV drip. It is a medical procedure that takes two to three hours, uses an apheresis machine that costs hundreds of thousands of dollars, requires a trained and certified apheresis nurse, and runs under direct physician supervision. Your blood is drawn out continuously, the plasma fraction is separated and discarded, fresh albumin solution replaces it, and your blood cells are returned to you. Vital signs are monitored the entire time.

That's the procedure itself. But what you're also paying for - and this matters more than most people realize - is what happens around the procedure. Do you get baseline labs before your first session? Do you get post-treatment labs to measure what actually changed? Does a physician review your results and adjust your protocol, or does someone hand you a packet and schedule your next appointment?

At Liondale, the pre- and post-treatment lab panel is included in every session. We measure inflammatory markers (CRP, IL-6, fibrinogen), metabolic panel, and where clinically relevant, epigenetic clock biomarkers. The cost reflects that. It reflects Dr. Bissoon personally reviewing every patient's results - not a nurse coordinator, not a remote sign-off. A physician who designed your protocol and is tracking your response. You leave knowing what changed, not just how you felt.

How Liondale Structures TPE

Before your first session, we do a full consultation and baseline lab draw. There is no point starting TPE without knowing where you are - your inflammatory burden, your metabolic markers, your current health status. That baseline is what we measure your response against.

For most patients, we recommend an initial series of three to six sessions. The frequency is determined by your labs and how you respond, not by a standard menu. Some patients come in monthly for the first series. Others space sessions every six to eight weeks. After the initial series, most patients move to quarterly or monthly maintenance depending on their labs and goals.

IVIG - intravenous immunoglobulin - may be added alongside TPE. The 2025 Aging Cell trial that produced the 2.61-year biological age reduction result used TPE with IVIG. TPE alone showed 1.32 years of reduction. Whether IVIG belongs in your protocol is a clinical decision, not a package add-on. We make that determination based on your individual case.

Most of the patients who come to us for TPE have already optimized the basics - sleep, diet, exercise, stress. They are coming in because they still have unexplained fatigue, persistent aches, brain fog, slower recovery from workouts, or a dip in energy and stamina that labs alone haven't explained. TPE is designed for exactly that gap.

Schedule a consultation to discuss your protocol and what a realistic treatment plan looks like for your situation. You can also learn more about how we approach TPE on our TPE service page.

TPE Cost in NYC: What Other Clinics Charge

There are three clinics in New York City currently offering TPE for longevity and anti-aging purposes. Their published pricing:

• Extension Health (West Village and Midtown East) - $10,000 per session, self-pay only. Dr. Albert Kuo. They have published their own data showing 77% BPA reduction after TPE, and their website has extensive educational content.
• Next Health (Flatiron) - $24,000 for three sessions, $45,000 for six sessions. A national chain with 15-plus locations. Their program includes a Baseline Test and Total Tox Burden Test. The experience is membership-based and integrates aesthetics with longevity services.
• Liondale Medical (Upper West Side) - pricing discussed at consultation. Boutique concierge practice. Circulate Health partner. Pre- and post-treatment lab tracking included every session.

For national context: MDLifespan starts at $5,995 per session. Dr. Allen P. Green in California publishes a range of $6,000 to $15,000. The variation in pricing reflects what is included - IVIG, lab panels, physician vs. nurse oversight, chain infrastructure vs. independent practice.

The cheapest option is not the wrong choice for every patient. But the lab tracking and physician oversight question is worth asking directly at any clinic you consider. Ask them: what do you measure before the first session, and what do you measure after? The answer tells you a lot.

Does Insurance Cover Therapeutic Plasma Exchange?

TPE for longevity is self-pay. Full stop. Insurance does not cover it for this purpose, and there is no billing code pathway that changes that. If a clinic suggests otherwise, ask them to put it in writing.

Insurance does cover TPE for FDA-approved medical indications: myasthenia gravis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy (CIDP), and several other autoimmune and neurological conditions. If you have one of those conditions and your physician orders TPE for that indication, your coverage may apply. But that is a different clinical situation entirely.

HSA and FSA funds may be applicable, depending on your plan. Some plans allow them for physician-ordered treatments. Others do not. We recommend confirming with your plan administrator before your first session - we have seen this go both ways.

Is It Worth the Cost?

This is the question I hear most often, and I want to answer it honestly rather than reassuringly.

The most significant clinical evidence we have comes from a randomized, placebo-controlled trial published in Aging Cell in May 2025, conducted by the Buck Institute for Research on Aging and Circulate Health. Forty-two healthy adults over 50. Participants who received TPE combined with IVIG showed an average biological age reduction of 2.61 years. TPE alone showed 1.32 years. The measurement used epigenetic clocks - widely used research biomarkers for biological age assessment. Only two participants discontinued across the trial.

That is real data. It is also early data. One trial, 42 participants. It does not prove that TPE will extend your lifespan. It does not prove you will look younger, feel younger, or live longer. What it shows is a measurable shift in biological age markers under controlled conditions. Whether that shift translates to clinical outcomes over a decade is the question researchers are working on now.

"Science is showing that while chronological aging is inevitable, biological aging is malleable. There's a part of it that you can fight."

- Dr. Eric Verdin, MD, Co-Founder of Circulate Health, CEO of Buck Institute for Research on Aging

In Circulate Health's post-procedure patient surveys, 90% of respondents reported satisfaction with their results - a self-report measure, not a clinical outcome, but one that reflects tolerability and patient experience. Circulate's work has been covered by the New York Times, Fortune, CNET, the Washington Post, and Axios. Liondale is a Circulate partner, which is how our protocols connect directly to the evidence base behind that coverage.

"Watching all my bloodwork numbers move into or towards the green gives me a lot of confidence in what I'm doing with TPE."

- Kevin MacDonald, age 63, Circulate Health patient

Whether TPE is worth the cost depends on your goals, your baseline health, and your tolerance for an elective medical procedure with early-stage evidence. The Aging Cell 2025 trial is a meaningful data point. It is one trial. That is the honest context.

What I tell patients who ask this question directly: if you have already addressed the foundations - sleep, diet, exercise, stress - and you are looking for an intervention with real mechanistic rationale and a published controlled trial, TPE deserves serious consideration. But it is not a shortcut for people who have not addressed the foundations. And it is not the right choice for every patient. That is what the consultation is for.

Safety Profile: What to Know Before Your First Session

Therapeutic plasma exchange has been used in clinical medicine for over 50 years. In large retrospective studies, serious adverse reactions occur in roughly 0.12% of procedures. Common side effects are mild and temporary: fatigue, lightheadedness, mild tingling from calcium shifts during the session, and occasional bruising at the IV site. Most patients report these resolve within 24 hours.

TPE is not appropriate for everyone. Patients with active bleeding disorders, certain clotting factor deficiencies, severe hemodynamic instability, or albumin allergy are not candidates. Patients taking anticoagulants or some immunosuppressants require individualized evaluation before proceeding. IVIG, when included in the protocol, carries its own separate contraindications and is only considered after physician review. The pre-consultation screening and baseline labs at Liondale are designed to identify these issues before treatment starts.

Frequently Asked Questions

How many sessions will I need?

Most patients start with three to six sessions in the initial series. The frequency is determined by your baseline labs and how your markers respond. After the initial series, most patients move to monthly or quarterly maintenance. There is no universal protocol - we design yours based on your data.

How long does each session take?

Plan for two to three hours per session, seated and comfortable. You can read, work on a laptop, or rest. One or two IV lines are placed at the start. Most patients tolerate the session well. Common immediate side effects include temporary fatigue or mild lightheadedness afterward, which typically resolve within a day.

What labs are included at Liondale?

Every patient receives a pre-treatment baseline panel and a post-treatment follow-up panel. We measure inflammatory markers (CRP, IL-6, fibrinogen), a metabolic panel, lipid panel, and where appropriate, epigenetic clock biomarkers. The goal is to have quantifiable data showing what changed, not just subjective reports.

What if I'm already doing NAD+ or other treatments?

Many patients combine TPE with NAD+ IV therapy, ozone therapy, or other longevity protocols. Whether that makes sense for you depends on your medications, recovery tolerance, and lab goals - which is what the consultation is for. In some cases we recommend sequencing treatments to avoid overlapping recovery windows. But most combinations are workable with appropriate planning.

Who should NOT do TPE?

Patients with active bleeding disorders, certain clotting factor deficiencies, severe hemodynamic instability, or albumin allergy are not candidates. Patients on certain medications (anticoagulants, some immunosuppressants) require careful evaluation before proceeding. The initial consultation and lab work identify these contraindications. If you are not a candidate, we tell you clearly and discuss alternatives.

Can I use HSA or FSA funds?

Possibly. Some HSA and FSA plans cover physician-ordered medical procedures. Others classify longevity treatments as elective and exclude them. We recommend confirming with your plan administrator before your first session. We can provide documentation of the clinical nature of the treatment to support your submission if needed.

How do I know if I'm responding?

That is exactly what the post-treatment lab panel tells you. We compare your inflammatory markers, metabolic panel, and biological age markers before and after each session. If the markers are not moving in the expected direction, we adjust the protocol. That is why the lab tracking matters - it turns a medical procedure into a measured intervention.

What are the side effects of TPE?

Common side effects are temporary: fatigue and mild lightheadedness on the day of the procedure, mild tingling from calcium shifts during the session, and occasional bruising at the IV site. These typically resolve within 24 hours. Serious adverse events are rare - retrospective studies across large TPE populations put the rate at roughly 0.12%. TPE has been used in hospital medicine for over 50 years, and its safety record is well-documented. We review your health history before your first session to confirm you are an appropriate candidate.

Is plasmapheresis the same as therapeutic plasma exchange, and does it cost the same?

Yes - plasmapheresis and therapeutic plasma exchange are the same procedure, described by different names. You may also see it called plasma exchange therapy or apheresis. The pricing is the same: $6,000 to $15,000 per session depending on clinic and protocol. The term "plasmapheresis" is more commonly used in a hospital or autoimmune treatment context; "therapeutic plasma exchange" is the language the longevity medicine community tends to use.

For a comparison of providers offering TPE in New York City, see our NYC TPE provider guide. For more on the microplastics and inflammatory toxin angles, see Can TPE remove microplastics from your blood?

This page was written and reviewed by Lionel Bissoon, D.O., founder of Liondale Medical. Dr. Bissoon is a board-certified osteopathic physician specializing in anti-aging and concierge medicine on the Upper West Side of Manhattan. Liondale Medical is a Circulate Health partner.

This content is for educational purposes only and does not constitute medical advice. Individual results may vary. Consult a qualified physician before beginning any new treatment.